Clinics and Practice最新文献

{"title":"Metabolic Syndrome as a Risk Factor Among Lebanese Patients with Substance Use Disorder Undergoing Treatment for Recovery Through Rehabilitation or Opioid Substitution Treatment.","authors":"Nadine Mahboub, Elissa Ayoub, Carine Mounzer, Tatiana Kate Baltagi, Dimitrios Papandreou, Nanne de Vries, Rana Rizk","doi":"10.3390/clinpract14060210","DOIUrl":"10.3390/clinpract14060210","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Data about metabolic syndrome (MS) in people who use drugs (PWUD) undergoing treatment for recovery are limited. We aimed to explore the extent of the MS and its predominant components and determinants in a sample of PWUD undergoing treatment for recovery through rehabilitation or opioid substitution treatment (OST) in Lebanon. Furthermore, we investigated the effect of each treatment modality on the MS; <b>Methods:</b> This was a cross-sectional study, in which demographics and treatment-related, nutritional, and biochemical data of the participants were collected. MS was defined according to the American Heart Association and the National Heart, Lung, and Blood Institute (AHA/NHLBI) criteria. Descriptive statistics were presented, and bivariate and multivariate analyses were conducted; <b>Results:</b> A total of 155 male subjects with the following characteristics were included: OST: n = 80; rehabilitation: n = 75; mean age: 32.53 ± 8.39 years; mean body mass index (BMI): 27.41 ± 4.99 Kg/m²; mean duration of treatment: 18 months. More than half of the sample had low HDL-C (56.8%) and/or elevated blood pressure (51.6%), 42.9% had elevated WC, 21.9% had elevated TG, and 12.3% had elevated FBS. Furthermore, 7.2% of the sample had no components of the MS, 29.2% had one component, 40.9% had two components, 16.9% had three components, and 5.8% had four components. MS was identified in 22.7% of the sample. Higher age was associated with higher odds of being diagnosed with MS (OR = 1.072; 95% CI: 1.021-1.126), whereas higher duration of current treatment was associated with lower odds (OR = 0.969; 95% CI: 0.944-0.995); <b>Conclusions:</b> MS and its components are prevalent in PWUD undergoing treatment for recovery. Routine screening and preventive measures are essential to prevent metabolic syndrome, particularly among older people and treatment newcomers.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 6","pages":"2661-2680"},"PeriodicalIF":1.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Sleep Disturbances and Chronic Pain: A Narrative Review.","authors":"Sejal V Jain, Geoffrey D Panjeton, Yuri Chaves Martins","doi":"10.3390/clinpract14060209","DOIUrl":"10.3390/clinpract14060209","url":null,"abstract":"<p><p>Sleep disturbances and chronic pain are prevalent and interrelated conditions that have significant impact on individuals' quality of life. Understanding the intricate dynamics between sleep and pain is crucial for developing effective treatments that enhance the well-being of affected individuals and reduce the economic burden of these debilitating conditions. This narrative review examines the complex relationship between sleep disturbances and chronic pain. We describe the prevalence and types of sleep disturbances and sleep disorders in chronic pain patients. Posteriorly, we critically review the clinical and experimental evidence, investigating the relationship between sleep disturbances and chronic pain, aiming to clarify the impact of chronic pain on sleep and, conversely, the impact of sleep disturbances on pain perception. In conclusion, the literature largely agrees on the existence of a bidirectional relationship between chronic pain and sleep disturbances, though the strength of each direction in this association remains uncertain. Current evidence suggests that sleep impairment more strongly predicts pain than pain does sleep impairment. Additionally, addressing sleep disturbances in chronic pain patients is crucial, as poor sleep has been linked to higher levels of disability, depression, and pain-related catastrophizing.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 6","pages":"2650-2660"},"PeriodicalIF":1.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Composition Changes and Factors Influencing the Total Weight Loss Rate After Laparoscopic Sleeve Gastrectomy.","authors":"Hironobu Nakaguchi, Bunzo Matsuura, Teruki Miyake, Hidenori Senba, Shinya Furukawa, Motohira Yoshida, Shigehiro Koga, Yuji Watanabe, Taro Oshikiri, Kumiko Toshimitsu, Yoichi Hiasa","doi":"10.3390/clinpract14060206","DOIUrl":"10.3390/clinpract14060206","url":null,"abstract":"<p><p><b>Objectives:</b> While the effectiveness of metabolic/bariatric surgery has been confirmed, understanding the factors associated with weight loss is paramount for providing guidance in postoperative treatment strategies. Here, we aimed to examine the factors associated with long-term maintenance of weight loss after laparoscopic sleeve gastrectomy (LSG). <b>Methods:</b> This prospective observational cohort included patients who underwent LSG at a single academic health center between January 2017 and June 2022. We examined their body composition using InBody 720 or 770 and analyzed the factors associated with the percentage of total weight loss (%TWL) for 24 months. <b>Results:</b> The median body mass index (BMI) was 38.8 (interquartile range [IQR]: 35.6-46.7) preoperatively, 32.7 kg/m² (IQR: 28.2-38.7) at 12 months postoperatively, and 33.9 kg/m² (IQR: 29.1-40.1) at 24 months postoperatively. The lowest BMI was observed at 12 months (<i>p</i> < 0.001 vs. preoperative), followed by a significant increase at 24 months (<i>p</i> = 0.003). However, BMI remained significantly lower at 24 months than preoperatively (<i>p</i> < 0.001). The skeletal muscle mass to fat mass ratio (SMM/FM) was 0.59 (IQR: 0.50-0.71) preoperatively, 0.79 (IQR: 0.58-1.26) at 12 months, and 0.70 (IQR: 0.54-1.05) at 24 months, peaking at 12 months (<i>p</i> < 0.001 vs. preoperative) and decreasing significantly by 24 months (<i>p</i> < 0.001). Nevertheless, the SMM/FM ratio at 24 months remained higher than preoperative values (<i>p</i> < 0.001). Median body weight and %TWL were 86.0 kg and 15.6%, respectively, at 24 months after LSG. The SMM/FM ratio at 12 months was positively correlated with %TWL at 24 months after adjusting for age and sex. <b>Conclusions:</b> The effects of LSG persisted for up to 24 months postoperatively. The SMM/FM ratio 12 months after LSG was associated with the rate of weight loss at 24 months.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 6","pages":"2608-2622"},"PeriodicalIF":1.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Self-Measuring Blood Pressure Program on Hypertension Control: Analysis by Diabetes Status, Age, Gender, and Race in Rural Arizona.","authors":"Joy Luzingu, Aminata Kilungo, Randall Flores, Zoe Baccam, Tenneh Turner-Warren, Thelma Reis, Babasola Okusanya, John Ehiri","doi":"10.3390/clinpract14060208","DOIUrl":"10.3390/clinpract14060208","url":null,"abstract":"<p><strong>Background: </strong>Rural areas face numerous health challenges, including workforce shortages, limited training opportunities, and delayed care. These disparities can be mitigated by self-management interventions for diseases such as hypertension. This study assessed the implementation of a Self-Measuring Blood Pressure (SMBP) program in rural Arizona, documenting its barriers and patient experiences.</p><p><strong>Methods: </strong>In this before-after study, participants were loaned a digital device which they used to self-measure and record blood pressure (BP) over 1 week or more for hypertension diagnosis or 4 weeks or more for monitoring. Blood pressure (BP) control was assessed per the guidelines of the American Heart Association and American Diabetes Association. BP changes between baseline and post-program were assessed using paired-Student t tests. Effect modification by diabetes was analyzed using stratification.</p><p><strong>Results: </strong>Among 740 participants, significant associations were found with gender, age, and controlled BP among non-diabetic patients. Post-intervention, 63.4% of diabetic patients showed controlled BP, and 25.7% of non-diabetic patients had controlled BP, with higher control rates among females and older age groups (60-79 years). Baseline mean SBP was 148.3 ± 19.6 mmHg, improving to 133.9 ± 14.6 mmHg; baseline DBP was 88.5 ± 33.6 mmHg, improving to 83.4 ± 9.6 mmHg.</p><p><strong>Conclusions: </strong>The SMBP program effectively controlled BP, highlighting the value of combining clinical care with telemonitoring.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 6","pages":"2637-2649"},"PeriodicalIF":1.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence and Modern Technology in Dentistry: Attitudes, Knowledge, Use, and Barriers Among Dentists in Croatia-A Survey-Based Study.","authors":"Ana Ivanišević, Antonija Tadin","doi":"10.3390/clinpract14060207","DOIUrl":"10.3390/clinpract14060207","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to assess Croatian dentists' knowledge, attitudes, and use of artificial intelligence (AI) and modern technology, while also identifying perceived barriers to AI and modern technology adoption and evaluating the need for further education and training.</p><p><strong>Materials and methods: </strong>A cross-sectional survey was conducted in February 2024 among general dentists in Croatia using a self-structured questionnaire. A total of 200 respondents filled out the questionnaire. It included five sections: socio-demographic and professional information, self-assessment of AI and modern technology use, knowledge of AI in dentistry, current innovations and devices used in practice, and barriers to AI and modern technology integration in practice. Data were analyzed using descriptive statistics and a regression analysis to explore relationships between socio-demographic factors and AI knowledge.</p><p><strong>Results: </strong>The mean knowledge of AI systems was 3.62 ± 2.56 out of a possible score of 7, indicating relatively poor knowledge, with 47.5% demonstrating knowledge below the median. Most respondents (76.0%) did not use AI systems and modern technology in practice; however, prosthodontics (13.0%) and oral surgery (10.0%) were identified as the primary fields utilizing these technologies. Respondents rated their knowledge of modern technologies and AI as weak or moderate, with 60.5% engaged in continuous education. Despite 76.0% not using AI daily, 71.0% believed that these technologies could enhance patient care. Participants interested in further training showed significantly better knowledge of AI applications (<i>p</i> = 0.030). Major barriers included acquisition and maintenance costs (59.0%) and financial constraints (58.0%).</p><p><strong>Conclusions: </strong>The study revealed that most respondents had poor knowledge of AI systems. Despite this, there is a recognition of AI's and modern technology potential in dentistry, emphasizing the need for enhanced education and training in this field.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 6","pages":"2623-2636"},"PeriodicalIF":1.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Acetazolamide to Prevent Acute Kidney Injury in Patients with Cancer on High-Dose Methotrexate Treatment: A Retrospective Pilot Analysis.","authors":"Lindon Lin, Tracey Batt, Gregory M Peterson","doi":"10.3390/clinpract14060205","DOIUrl":"10.3390/clinpract14060205","url":null,"abstract":"<p><p><b>Background:</b> High-dose methotrexate (HDMTX) chemotherapy is associated with a significant risk of acute kidney injury (AKI). Acetazolamide is thought to increase methotrexate solubility via urinary alkalinisation, potentially reducing the risk of crystalline nephropathy. A tertiary hospital has included acetazolamide in its HDMTX protocols, although data on the risks and benefits are limited. This study evaluated the role of acetazolamide in managing patients receiving HDMTX and identified risk factors for AKI. <b>Methods:</b> The retrospective cohort pilot study included consecutive hospital patients who received HDMTX (≥500 mg/m²). Data collected from digital medical records included demographics, comorbidities, methotrexate dosages and serum concentrations, and pathology results. The development of AKI was defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Relationships between variables and AKI were initially assessed using Mann-Whitney U-tests and chi-square tests, and significant variables were further analysed using logistic regression to identify independent predictors of AKI. <b>Results:</b> Among 66 HDMTX treatment cycles in 31 patients, AKI occurred in 0/7 cycles with acetazolamide versus 14/59 cycles without (<i>p</i> = 0.33). Increasing age, the presence of hypertension, and concurrent use of beta-lactam antibiotics were associated with the development of AKI. Age was identified as the strongest independent risk factor for AKI (odds ratio 1.12, <i>p</i> = 0.034). <b>Conclusions:</b> Optimising management protocols, especially for older patients, is essential to reduce AKI risk during HDMTX therapy. While acetazolamide did not appear to reduce the risk of AKI, this pilot study was limited by a small sample size. Large randomised controlled trials are needed to assess efficacy and patient outcomes.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 6","pages":"2601-2607"},"PeriodicalIF":1.7,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Success of Pulpotomies Using Intermediate Restorations and Preformed Metal Crowns in the Context of a Developing Country: A Retrospective Questionnaire-Based Investigation.","authors":"Ana Luisa Montero-Copoya, Norma Leticia Robles-Bermeo, Salvador Eduardo Lucas-Rincón, María de Lourdes Márquez-Corona, Saraí Carmina Guadarrama-Reyes, Nayeli Lovera-Rojas, Juan Fernando Casanova-Rosado, Juan José Villalobos-Rodelo, Mauricio Escoffié-Ramírez, Carlo Eduardo Medina-Solís","doi":"10.3390/clinpract14060203","DOIUrl":"10.3390/clinpract14060203","url":null,"abstract":"<p><p><b>Background:</b> Dental caries is one of the most prevalent dental illnesses in children. Untreated severe caries can damage teeth, requiring pulpotomy to save them. <b>Objective:</b> To evaluate the clinical success rate of treatments involving pulpotomies + IRM (Intermediate Restorative Material, composed of reinforced zinc oxide-eugenol polymers) + preformed metal crowns (PMCs) in primary teeth of children treated at a public university in Mexico. <b>Materials and Methods:</b> A cross-sectional ambispective study was conducted on children aged 10 years or younger, treated at a public university in Mexico. A total of 1281 medical records from February 2018 to June 2023 were reviewed, yielding a sample of 199 children treated with pulpotomy + IRM + PMC. Information was collected via telephone interviews with parents/caregivers to inquire about any symptoms following the pulpotomy and metal crown treatments. Success was defined as the absence of pain, inflammation, or infection. <b>Results:</b> During the study period, the number of teeth treated with pulpotomy + IRM + PMC was 414, with follow-ups ranging from 6 to 69 months. Most participants were girls (54.3%), while 45.7% were boys. Out of the 167 pulpotomy + IRM + PMC treatments included in the study, the clinical success rate was 98.2%. <b>Conclusions:</b> The clinical success rate of primary teeth treated with pulpotomy + IRM + PMCs was high, close to 100%, based on evidence and symptom reports from parents/caregivers. It would be beneficial to implement its use in public health institutions in countries such as Mexico.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 6","pages":"2580-2589"},"PeriodicalIF":1.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Impact of Maternal Lipid Profiles on Fetal Cardiac Function at Mid-Gestation: An Observational Study.","authors":"Biliana Belovan, Zoran Laurentiu Popa, Cosmin Citu, Ioana Mihaela Citu, Ioan Sas, Adrian Ratiu","doi":"10.3390/clinpract14060204","DOIUrl":"10.3390/clinpract14060204","url":null,"abstract":"<p><p><b>Background:</b> Maternal dyslipidemia during pregnancy may influence fetal cardiac development and function, potentially predisposing offspring to cardiovascular diseases later in life. This study aims to evaluate the relationship between maternal lipid profiles and fetal cardiac function at mid-gestation, utilizing detailed echocardiographic assessments. <b>Methods:</b> In this prospective cohort study conducted at the Obstetrics and Gynecology Clinic of the Timișoara Municipal Emergency Hospital, 19 pregnant women aged 27-40 years were recruited and divided into two groups based on their triglyceride levels: Group A (triglycerides ≤ 150 mg/dL, <i>n</i> = 48) and Group B (triglycerides > 150 mg/dL, <i>n =</i> 28). Maternal demographic data and lipid profiles were recorded. Fetal echocardiographic measurements, including global longitudinal strain and ventricular function parameters, were obtained between 20 and 24 weeks of gestation. Statistical analyses, including subgroup comparisons, correlations, and regression analyses, were performed. <b>Results:</b> Maternal BMI was significantly higher in Group B compared to Group A (31.94 ± 2.80 vs. 27.01 ± 2.40 kg/m², <i>p</i> < 0.001). Group B showed higher mean triglyceride levels (163.43 ± 11.34 mg/dL) compared to Group A (131.42 ± 10.57 mg/dL, <i>p</i> < 0.001). Fetal echocardiographic measurements indicated reduced global longitudinal strain in fetuses of Group B mothers (LV strain: -19.86% ± 6.83% vs. -26.14% ± 5.92%, <i>p</i> = 0.017). Significant correlations were found between maternal triglyceride levels and fetal LV strain (<i>r =</i> 0.536, <i>p</i> = 0.019). Regression analysis identified maternal triglyceride levels and BMI as significant predictors of reduced fetal LV strain (β = 0.45, <i>p</i> = 0.021 and β = 0.39, <i>p</i> = 0.038, respectively). <b>Conclusions:</b> Elevated maternal triglyceride levels, LDL cholesterol, and BMI are associated with altered fetal cardiac function parameters at mid-gestation, suggesting that maternal lipid profiles may impact fetal cardiac development. These findings underscore the importance of monitoring lipid levels during pregnancy and suggest potential benefits of managing dyslipidemia to improve fetal cardiac outcomes. However, the study included only a small sample; therefore, the study needs to be continued with a larger group.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 6","pages":"2590-2600"},"PeriodicalIF":1.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Effects of the Mandibular Muscle Energy Technique in Adults with Chronic Temporomandibular Disorder.","authors":"Antonio Márquez-Vera, Luis Polo-Ferrero, Ana Silvia Puente-González, Roberto Méndez-Sánchez, José Antonio Blanco-Rueda","doi":"10.3390/clinpract14060202","DOIUrl":"10.3390/clinpract14060202","url":null,"abstract":"<p><strong>Background/objectives: </strong>Temporomandibular disorders affect the muscles used for chewing, the temporomandibular joint, and other related tissues, resulting in pain, limited mobility, and dysfunction of the masticatory muscles. Physical therapy plays a critical role in treatment. Manual therapy can trigger neurophysiological mechanisms that contribute to pain relief and a reduction in muscle activation. Evaluations of different manual therapy techniques are needed on this topic. The main objective of this study was to evaluate the effects of a specific manual therapy technique (the mandibular muscle energy technique) in adults with temporomandibular disorders.</p><p><strong>Methods: </strong>A randomized, parallel clinical trial was conducted, and 31 participants were recruited into an experimental group and 30 were recruited into a control group in order to analyze its effects on outcomes such as pain, pain threshold to pressure, mandibular mobility, and kinesiophobia. Pre- and post-intervention assessments were performed, followed by statistical analyses to verify the intra- and intergroup changes.</p><p><strong>Results: </strong>The results showed that the mandibular muscle energy technique produced positive effects with significant differences in the intra- and intergroup comparisons for pain threshold to pressure, mandibular mobility, and kinesiophobia, demonstrating its efficacy and safety as a treatment option for adults with temporomandibular disorders, with proven effects in the short term.</p><p><strong>Conclusions: </strong>The effects obtained and the absence of side effects showed that this technique can be integrated into multimodal treatment along with other types of interventions in patients with temporomandibular disorders.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 6","pages":"2568-2579"},"PeriodicalIF":1.7,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11674239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Dysfunction-Associated Steatotic Liver Disease in Chronic Hepatitis C Virus Infection: From Basics to Clinical and Nutritional Management.","authors":"Karina Gonzalez-Aldaco, Luis A Torres-Reyes, Claudia Ojeda-Granados, Leonardo Leal-Mercado, Sonia Roman, Arturo Panduro","doi":"10.3390/clinpract14060200","DOIUrl":"10.3390/clinpract14060200","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely associated with obesity and other cardiometabolic risk factors. MASLD has rapidly become the most common cause of liver disease worldwide, currently affecting 38% of the global population. Excess weight causes chronic inflammation and the activation of different pathways involved in liver damage. MASLD can progress from simple steatosis to steatohepatitis, giving way to its inflammatory component, metabolic dysfunction-associated steatohepatitis (MASH), previously recognized as non-alcoholic steatosis hepatitis (NASH). Chronic hepatitis C virus (HCV) infection remains a significant challenge to liver health as it triggers hepatic inflammation, metabolic disruption, and hepatic steatosis. The convergence of MASLD and chronic HCV infection can significantly alter the course of liver disease and accelerate the progression to severe liver damage. Currently, HCV treatment has a high cure rate. However, in patients who achieve a sustained virological response after treatment with direct-acting antivirals, weight gain, and excessive calorie intake may contribute to increased liver steatosis and a higher risk of liver disease progression. Therefore, the effective clinical and nutritional management of HCV patients, both before and after viral eradication, is crucial to reducing the risk of death from hepatocellular carcinoma. Understanding the complex interactions between MASLD and HCV infection is crucial for managing these patients appropriately. Herein, host and viral mechanisms inducing liver damage during the coexistence of MASLD and HCV infection are described, and their therapeutic and dietary management are discussed.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"14 6","pages":"2542-2558"},"PeriodicalIF":1.7,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}